From the Guidelines
Yes, ADHD and depression are related conditions that frequently co-occur, with approximately 30-40% of adults with ADHD also experiencing depression at some point in their lives. The relationship between ADHD and depression is complex, with the ongoing challenges of managing ADHD symptoms like difficulty concentrating, impulsivity, and organizational problems leading to chronic stress, feelings of inadequacy, and eventual depression 1. Additionally, both conditions share some neurobiological underpinnings, particularly involving dopamine and norepinephrine systems in the brain.
Some key points to consider in the relationship between ADHD and depression include:
- The high comorbidity rate between the two conditions, suggesting a need for comprehensive treatment plans that address both ADHD and depression symptoms 1.
- The potential for ADHD medications, such as stimulants, to have some effect on depression symptoms due to their impact on neurotransmitter systems, although they are not a replacement for dedicated depression treatment 1.
- The importance of a thorough diagnostic process to identify comorbid conditions, including depression, in individuals with ADHD, to ensure appropriate and effective treatment strategies are implemented.
In terms of treatment, a combination of medication and therapy is often necessary to address both ADHD and depression effectively. This might include the use of an SSRI antidepressant alongside ADHD medication, coupled with cognitive behavioral therapy to address negative thought patterns and develop coping strategies for both conditions 1. It's crucial to approach each patient's situation individually, considering the severity of their ADHD and depression symptoms, as well as any other comorbid conditions that may be present, to tailor the treatment plan accordingly.
From the FDA Drug Label
Co-morbidities occurring with ADHD may be associated with an increase in the risk of suicidal ideation and/or behavior. The answer is yes, ADHD can be related to depression, as co-morbidities (including depression) occurring with ADHD may increase the risk of suicidal ideation and/or behavior 2.
- Key points:
- ADHD may have co-morbidities that increase the risk of suicidal ideation and/or behavior
- Depression is a potential co-morbidity of ADHD
- Patients with ADHD should be monitored closely for suicidality, clinical worsening, or unusual changes in behavior 2
From the Research
Relationship Between ADHD and Depression
- ADHD has been identified as a significant risk factor for the development of later depression 3
- Adults with ADHD are at increased risk for depressive disorders 4
- Comorbidity between ADHD and major depression has been reported from both epidemiologic and clinical studies of both children and adults 5
Prevalence of ADHD in Depressed Individuals
- 12.8% of recurrently depressed women had elevated ADHD symptoms and 3.4% met DSM-5 diagnostic criteria for ADHD 6
- ADHD symptoms were associated with earlier age of depression onset, higher depression associated impairment, and increased persistence of subthreshold depression symptoms 6
Mechanisms of Risk
- Cognitive-behavioral factors, such as dysfunctional attitudes and cognitive-behavioral avoidance, may account for variance in depressive symptoms and disorder in adults with ADHD 4
- Reward responsivity, emotion dysregulation, and parenting/family factors may also contribute to the development of depression in individuals with ADHD 3
Treatment Implications
- Adjunctive treatment with psychostimulants may be a safe and effective intervention for individuals with persistent ADHD symptoms and comorbid depression 7
- Interventions targeting cognitive-behavioral factors, such as cognitive behavior therapy (CBT), may be beneficial for individuals with ADHD and comorbid depression 4
- The possibility of underlying ADHD masked by depression should be considered in individuals with early onset, impairing, and recurrent depression 6